216. Multiplex real-time PCR in the diagnosis of acute diarrhea in children in Luanda, Angola
Session: Poster Abstract Session: Diagnostics: Enteric Infection
Thursday, October 27, 2016
Room: Poster Hall
  • Multiplex real-time PCR in the diagnosis of acute diarrhea in children in Luanda, Angola.pdf (518.6 kB)
  • Background:  Diarrhea is globally the second leading cause of death in children under five, killing around 1,500 children every day. In diagnostics, molecular methods which can detect several pathogens with high sensitivity are replacing traditional assays. We aimed to investigate enteropathogens in children with and without diarrhea in Luanda, the capital of Angola.

    Methods:  We examined 200 stool samples from 101 children with acute diarrhea and 99 children without diarrhea, respectively, in the Pediatric Hospital of Luanda with multiplex real-time polymerase chain reaction (PCR) searching for 17 enteropathogens.

    Results: The median age of children was 11 months (IQR 17). Enteropathogens, bacteria, viruses, and parasites were detected in 181 (91%), 157 (79%), 99 (50%), and 49 (25%) samples, respectively. The number of positive samples differed significantly between children with and those without diarrhea when testing for all pathogens combined (97 vs 84, p=0.008), for bacteria (88 vs 69, p=0.003), and for viruses (65 vs 34, p<0.0001). In contrast, no such difference was found for parasites (29 vs 20, p= 0.16). Mixed infections with more than one pathogen group was found in 103/181 (57%) of all, in 68/97 (72%) of children with, and in 35/84 (42%) of those without diarrhea (p=0.0001). More than one pathogen was found in 133/181 (74%) of all, in 84/97 (87%) of children with, and in 49/84 (58%) of children without diarrhea (p<0.0001). In diarrhea vs without diarrhea groups, the median number (IQR) of pathogens detected was 3(2) vs 1(2) (p<0.0001); of bacteria 2(2) vs 1(2) (p<0.0001), and of viruses 1(1) vs 0(1) (p<0.0001). When age and malnutrition were taken into account, diarrhea associated with enterotoxigenic and enteroaggregative Escherichia coli, Shigella, Campylobacter, rotavirus, sapovirus, and Cryptosporidium.

    Conclusion: Multiplex PCR detected enteropathogens in almost all stool samples of children in Luanda. However, in children with diarrhea this occurred more often; they showed more mixed infections with different pathogen species and pathogen groups than children without diarrhea.

    Tuula Pelkonen, MD, PhD1,2,3, Irmeli Roine, MD, PhD4, Elisabete Dos Anjos, Lic.A Psych1, César Freitas, MD1, Heikki Peltola, MD, PhD, Professor2,3, Sanna Laakso, MSC, PhD5 and Juha Kirveskari, MD, PhD5, (1)Hospital Pediátrico David Bernardino, Luanda, Angola, (2)Children’s Hospital, Helsinki University Hospital, Helsinki, Finland, (3)Faculty of Medicine, University of Helsinki, Helsinki, Finland, (4)Faculty of Medicine, University Diego Portales, Santiago, Chile, (5)Mobidiag ltd, Espoo, Finland


    T. Pelkonen, None

    I. Roine, None

    E. Dos Anjos, None

    C. Freitas, None

    H. Peltola, None

    S. Laakso, Mobidiag ltd: Employee , Salary

    J. Kirveskari, Mobidiag ltd: Board Member and Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.